Oral transit time in children with neurological impairment indicated for gastrostomy

Area of Science:

• Pediatric Gastroenterology
• Neurology
• Swallowing Disorders

Background:

• Children with neurological impairment (CNI) often face feeding difficulties.
• Gastrostomy indication in CNI suggests significant oral feeding challenges.
• Understanding oral transit time (TOTT) is crucial for managing pediatric feeding issues.

Purpose of the Study:

• To quantify the total oral transit time (TOTT) in children with neurological impairment (CNI).
• To assess TOTT in CNI children who have an indication for gastrostomy.
• To compare TOTT for different food consistencies in this pediatric population.

Main Methods:

• A cross-sectional clinical study involving 15 children (ages 1-14) with CNI and gastrostomy indication.
• Videofluoroscopy swallowing studies were used to analyze swallowing function.
• Total oral transit time (TOTT) was measured using specialized software for pureed and liquid consistencies.

Main Results:

• The mean TOTT for pureed food was 10.75 s (SD 11.76 s).
• The mean TOTT for liquid food was 4.22 s (SD 1.54 s).
• These TOTT values were categorized as long based on existing literature definitions.

Conclusions:

• Children with neurological impairment and a gastrostomy indication exhibit prolonged TOTT.
• Both pureed and liquid food consistencies presented with extended oral transit times.
• Findings suggest significant oral phase dysphagia in CNI children necessitating feeding support.